Awareness during Caesarean section

Abstract

Between 1982 and 1989 over 3000 patients were questioned about recall and dreaming after general anaesthesia for Caesarean section. Some 28 (0.9%) patients were able to recall something of their operation and 189 (6.1%) reported dreams. There was uniform adherence to a rigid anaesthetic protocol up to and including 1985, but a much publicised incident reported from the courtroom stimulated a relaxation of this regimen. Consequently the incidence of awareness decreased from 1.3% to 0.4%, and the incidence of dreaming was also reduced. Recollections of surgery were confined to manipulations, noises and voices. None of our patients complained of pain at the time of interview, although one since has. The inadequacies of the initial protocol and an approach to informed consent are discussed.